TY - JOUR
T1 - Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers
AU - Mistry, Rakesh D.
AU - Hogan, Patrick G.
AU - Parrish, Katelyn L.
AU - Thompson, Ryley M.
AU - Fritz, Stephanie A.
N1 - Funding Information:
Supported by the Agency for Healthcare Research and Quality (AHRQ, R01-HS024269 to S.A.F.) and the National Institutes of Health/National Center for Advancing Translational Sciences (grant number UL1-TR002345 to S.A.F.). These funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or AHRQ. The authors thank the American Academy of Pediatrics Section on Emergency Medicine Survey Subcommittee and the Pediatric Emergency Medicine Collaborative Research Committee for their assistance in conducting this study.
Funding Information:
Supported by the Agency for Healthcare Research and Quality (AHRQ, R01-HS024269 to S.A.F.) and the National Institutes of Health/National Center for Advancing Translational Sciences (grant number UL1-TR002345 to S.A.F.). These funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or AHRQ.
Publisher Copyright:
© 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Objective: The aim of the study was to evaluate skin and soft tissue infection (SSTI) treatment and prevention practices among pediatric emergency medicine (PEM) clinicians in the context of current clinical practice guidelines and contemporary evidence. Methods: This was a cross-sectional survey of PEM clinicians belonging to the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. Four varying hypothetical clinical scenarios of children with SSTI were posed to respondents; subsequent items assessed SSTI treatment and prevention practices. Provider demographics were collected. Results: Of 160 survey respondents, more than half stated that they would prescribe oral antibiotics for each clinical scenario, particularly for more complex presentations (small uncomplicated abscess, 51.8%; large uncomplicated abscess, 71.5%; recurrent abscess, 83.5%; febrile abscess, 90.3%; P < 0.001). Most commonly selected antibiotics were clindamycin and trimethoprim-sulfamethoxazole. Across scenarios, more than 80% selected a duration of treatment 7 days or more. Of the 121 respondents who prescribe preventive measures, 85.1% recommend hygiene measures; 52.5% would prescribe decolonization with topical antibiotic ointment and 77.5% would recommend antiseptic body washes. Half of the respondents reported that their institution has standard guidance for SSTI management. Conclusions: Although current evidence supports adjuvant antibiotics for all drained SSTI and decolonization for the index patient and household contacts, PEM clinicians do not consistently adhere to these recommendations. In light of these findings, development and implementation of institutional guidelines are necessary to aid PEM clinicians' point-of-care decision making and improving evidence-based practice.
AB - Objective: The aim of the study was to evaluate skin and soft tissue infection (SSTI) treatment and prevention practices among pediatric emergency medicine (PEM) clinicians in the context of current clinical practice guidelines and contemporary evidence. Methods: This was a cross-sectional survey of PEM clinicians belonging to the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. Four varying hypothetical clinical scenarios of children with SSTI were posed to respondents; subsequent items assessed SSTI treatment and prevention practices. Provider demographics were collected. Results: Of 160 survey respondents, more than half stated that they would prescribe oral antibiotics for each clinical scenario, particularly for more complex presentations (small uncomplicated abscess, 51.8%; large uncomplicated abscess, 71.5%; recurrent abscess, 83.5%; febrile abscess, 90.3%; P < 0.001). Most commonly selected antibiotics were clindamycin and trimethoprim-sulfamethoxazole. Across scenarios, more than 80% selected a duration of treatment 7 days or more. Of the 121 respondents who prescribe preventive measures, 85.1% recommend hygiene measures; 52.5% would prescribe decolonization with topical antibiotic ointment and 77.5% would recommend antiseptic body washes. Half of the respondents reported that their institution has standard guidance for SSTI management. Conclusions: Although current evidence supports adjuvant antibiotics for all drained SSTI and decolonization for the index patient and household contacts, PEM clinicians do not consistently adhere to these recommendations. In light of these findings, development and implementation of institutional guidelines are necessary to aid PEM clinicians' point-of-care decision making and improving evidence-based practice.
KW - Staphylococcus aureus
KW - antibiotics
KW - decolonization
KW - skin and soft tissue infection
UR - http://www.scopus.com/inward/record.url?scp=85133214472&partnerID=8YFLogxK
U2 - 10.1097/PEC.0000000000002618
DO - 10.1097/PEC.0000000000002618
M3 - Article
C2 - 35766929
AN - SCOPUS:85133214472
SN - 0749-5161
VL - 38
SP - E1348-E1354
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 7
ER -